Shita Dewi

From Research to Policy How Indonesia PHSA results influenced policy

Outline

BackgroundWhat we didResults

Indonesia PHSA

In 2009 we examined the recent growth of private hospital services in Indonesia, in collaboration with the Nossal Institute for

Global Health, funded by AusAID.

Objectives: to identify factors contributing to and

impacting the growth of private hospitalsto explore potential regulatory and policy

responses

Indonesia PHSA Results

1. There is a long tradition of charitable and religious based service provision in Indonesia even before the public system was established.

2. During the last 10 years, NFP hospitals growth has stagnated (some converted to for-profit hospitals), while the growth of for-profit hospitals has doubled.

3. For-profit hospitals and NFP hospitals face the same tax and levies burden.

4. There are some disincentive regulations that restrict the growth of for-profit hospitals.

Hospital Providers

Public

Private Nonprofit

Private for Profit Limited Company

Private Nonprofit Community Associa-tion

What we did:

Premise: there should be a policy change to support NFP hospitals to ensure their sustainability

Strategy: Stakeholder engagementFirst, we identified the immediate

stakeholders, namely the NFP hospital associations, to engage them in the policy community dialogue.

Then, we identified policy champions in the National parliament and the Ministry of Health (MOH).

How we did it:Individual meetings

of the policy champions in NFP

hospital associations and

the MOH

Arranged a study visit to Australia with delegates comprised of

representatives of the NFP hospitals associations, the

MOH, and the media

Established an informal NFP

hospitals forum that meets quarterly

Published articles and special report

concerning the NFP hospital in a

national newspaper

Arranged a NFP hospitals panel

presentation and discussion in the annual private

hospital national conference

Initiated digital communications

including website, on-line forums and blogs targeted to

the NFP policy community

Distributed policy briefs to the MOH

and National parliament

One-on-one advocacy to the

policy champions among the National

Parliament members

The results, so far

The Hospital Act (2009) distinguished for-profit and NFP hospitals for the first

timeacknowledged the rights to tax incentives for the NFP

hospitals

Challenges: need to develop regulations to give effect to this provision.

MOH should define specific criteria of NFP hospital Ministry of Finance should regulate the tax incentives

The results, so far cont’d

The MOH Task ForceThe task force consists of an academic

representative, representatives of the NFP hospital associations (six people), and representatives of MOH (three people)

At the end of 2010 the task force developed a Brief to the Minister of HealthChallenge 1: turning the Brief into a legal

operational regulationChallenge 2: advocating the case to the MOF